早期整形手术联合康复锻炼对深Ⅱ度烧伤关节功能障碍患者膝关节功能及预后的影响

Effect of early plastic surgery combined with rehabilitation exercise on knee joint function and prognosis in patients with deep second degree burn joint dysfunction

目的探究早期整形手术联合康复锻炼对深Ⅱ度烧伤关节功能障碍患者膝关节功能及预后的影响,分析其临床应用价值。方法回顾性分析本院2012年3月至2017年10月收治的79例深Ⅱ度烧伤创面愈合后膝关节功能障碍患者的临床资料。按照患者治疗方案,将仅行康复锻炼者纳入对照组(42例),将接受早期整形手术联合康复锻炼者纳入观察组(37例)。对比两组患者创面愈合后第3、6、12个月关节功能恢复情况,以及美国膝关节外科学会膝关节功能评分(keen society score,KSS)变化,分析两种方案对患者膝关节功能及预后的影响。结果两组患者创面愈合后12个月关节功能优良率、KSS评分均显著高于本组创面愈合后3个月(P_均<0.05),观察组患者创面愈合后3、6、12个月关节功能优良率和KSS评分均显著高于同期对照组(P_均<0.05)。创面愈合后12个月,观察组患者治疗总有效率显著高于对照组(P <0.05)。结论在康复锻炼的基础上实施早期整形手术,可改善深Ⅱ度烧伤关节功能障碍患者的膝关节功能及预后,值得推广应用。

Objective To explore the effect of early plastic surgery combined with rehabilitation exercise on knee joint function and prognosis of patients with deep second degree burn joint dysfunction,and to analyze its clinical value.Method The clinical data of 79 patients with knee joint dysfunction after deep second degree burn wound healing from March 2012 to October 2017 were collected and analyzed retrospectively.According to the patient’s treatment plan,those who only took rehabilitation exercise were included in control group(42 cases),and those who received early plastic surgery combined with rehabilitation exercise were included in observation group(37 cases).The recovery of knee joint function and the change of knee society score(KSS)of American Academy of knee surgery were compared between the two groups at 3,6 and 12 months after wound healing.The effects of the two schemes on knee joint function and prognosis were analyzed.Result The excellent rate of joint function and KSS score of the two groups at 12 months after wound healing were higher than those of 3 months after wound healing(Pall<0.05).The excellent rate of joint function and KSS score of observation group at 3 months,6 months and 12 months after wound healing were higher than those of control group at the same time(Pall<0.05).12 months after wound healing,the total effective rate of observation group was significantly higher than that of control group(P<0.05).Conclusion On the basis of rehabilitation exercise,early plastic surgery for deep second degree burn patients with joint dysfunction is helpful to improve knee joint function and prognosis,worthy of clinical popularization and application.